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At least 145 records · Page 8Linked to original sources
PubMed1987

[Bore wire osteosynthesis in injuries of the foot].

Severe foot lesions with fractures and/or dislocations require the best reconstruction of form and function. The essential prerequisite for an undisturbed healing consists of an exact reduction with reconstruction of skeletal foot structure by osteosynthesis according to the lesions of the soft tissue. In case of extended lesions of the soft tissue, the closed reduction with reconstruction of the vault of the foot and the retention with Kirschner-wires, if necessary combined with a fixateur externe, has proven to be successful for stabilization.

Adult↗
PubMed1998

Tendon transfer with a microvascular free flap for injured feet in children.

We reviewed 11 patients who had been treated between January 1986 and June 1994 for severe foot injuries by tendon transfer with microvascular free flaps. Their mean age was 5.6 years (3 to 8). Five had simultaneous tendon transfer and a microvascular free flap and six had separate operations. The mean interval between the tendon transfer and the microvascular free flap was 5.8 months (2 to 15) and the mean time between the initial injury and the tendon transfer was 9.6 months (2 to 21). The anterior tibial tendon was split in five of six cases. The posterior tibial tendon was used three times and the extensor digitorum longus tendon twice. The mean follow-up was 39.7 months (24 to 126). There were nine excellent and two good results. Postoperative complications included loosening of the transferred tendon (2), plantar flexion contracture (1) mild flat foot deformity (1) and hypertrophic scars (2). We recommend tendon transfer with a microvascular free flap in children with foot injuries combined with nerve injury and extensive loss of skin, soft tissue and tendon.

Ankle Joint↗
PubMed2001

Early soft tissue coverage after complex foot trauma.

Complex foot injuries require early and durable soft tissue coverage to reduce infection rates and fibrosis, thereby improving the functional outcome. Definitive wound closure with tissue transfer was achieved as an emergency procedure within 24 hours in 2 of 28 cases, as urgent revision within 72 hours in 9 of 28 cases, and as early revision within 120 hours in 15 of 28 patients. To evaluate the global foot function the Maryland Foot Score was applied to 17 of 28 patients at the 1-year follow-up. The mean score was 74.2 (of 100) points, indicating "good" to "sufficient" foot function. The outcome was superior compared with a series of 18 consecutive open calcaneus fractures with delayed soft tissue coverage (64.4 points). These results were confirmed with a modified Merle d'Aubigné Score. The overall infection rate could be lowered to 7.1% after complex foot injuries with early soft tissue coverage compared to 26 open calcaneus fractures (19.2%). Functional scores allow a reasonable overall assessment of the results, but they are centered on subjective criteria. Thus they must be viewed in conjunction with radiologic and biometric factors as well as criteria valuable for plastic reconstruction, such as two-point discrimination and durability. Unfortunately, emergency flap procedures are still rare in foot surgery, although they permit primary stable osteosynthesis even with complex foot trauma. The foot should gain the same functional rank as the hand with respect to acute or emergency flap procedures to avoid further complications.

Adolescent↗
PubMedDate not supplied

[Usefulness of Ottawa rules for acute injuries of ankle and foot].

OBJECTIVE: To analyze the usefulness of the rules of Ottawa in the diagnosis of foot and ankle injuries. MATERIAL AND METHODS: To design a diagnostic test. SITE: Emergency room at Magdalena de las Salinas Trauma Hospital. PARTICIPANTS: Adults with injuries of foot and ankle taken care in January 2003. SAMPLING: Non-probabilistic by convenience. INTERVENTIONS: Patients who went for attention due to foot and ankle injuries without evident deformity were asked to went through X-rays, and they were assessed by means of the following criteria: a) pain or increase in sensitivity of the later edge and end of lateral and medial malleolus, in the 6 cm distal; b) pain or increase in the sensitivity of the navicular bone or base of the fifth metatarsal, and, c) inability to support their weight immediately after the injury and during the physical exploration. The presence of one or more criteria are indicative of X-rays. MEASUREMENTS: sensitivity, specificity, predictive values (PV), and probability rates (PR). RESULTS: 50 ankles were studied, correlating the clinical test with the X-rays (gold standard). The clinical test showed a sensitivity of 100%, specificity of 60%, PVP of 30%, PVN of 100%, RFP of 40%, and, RFN of 0, PR/RPP of 3, PR/RPN of 0. CONCLUSIONS: In the injuries of ankle, when the Ottawa rules are negative, the X-rays series are not indicated, since the probability of not having a fracture can be of 100%. When it has one or more criteria, if we asked for the X-rays, a third part of the patients can have fracture with a rate of false positives of 40%. Apparently, in ankle and foot injuries, certain studies are not essential without having any deterioration of the quality medical care.

Adult↗
PubMed2004

Pictorial review: MRI features of foot and ankle injuries in ballet dancers.

Foot and ankle pain is common in ballet dancers. Although clinical examination often points to the underlying cause, imaging is often necessary to confirm the diagnosis and thus ensure appropriate future management. Factors predisposing to the increased incidence of injuries in this population include the classical position in which ballet dancers stand, which is on the tips of the toes in the en pointe position or on the balls of the feet in the demi-pointe position. Furthermore, the repetitious nature of ballet and the long hours spent rehearsing cause over-use injuries. The causes of foot and ankle pain can be thought of in four different groups: the impingement syndromes; tendon abnormalities; osseous pathology; and ligament abnormalities. These will be discussed and illustrated.

Adolescent↗
PubMed2006

Fractures and dislocations of the foot in children.

The challenge of managing pediatric foot injuries is the identification of the rare injuries that require operative treatment and the management of complications such as compartment syndrome, post-traumatic foot deformities, and avascular necrosis. With these complications in mind, the authors discuss fractures of the talus, calcaneus, lesser tarsal bones, Lisfranc's joint, metarsals, and phalanges. Dislocation of metatarsophalangeal or interphalangeal joints is also discussed.

Child↗
PubMedDate not supplied

Arthroscopic evaluation of traumatic injuries to the ankle and foot. Part I: Acute injuries.

Traumatic osseous and soft tissue injuries of the ankle have enjoyed significant attention in the world literature. Technologic advances over the past 3 decades have allowed investigators to develop parallel methods of treatment of surgical approaches to fractures and soft tissue injuries of diarthrodial joints. The result is the art, science, and technology of arthroscopic surgery.

Ankle↗
PubMed2001

Vaccum assisted closure: an alternative strategy in the management of degloving injuries of the foot.

A case of a degloving injury to the foot is presented in a patient who also sustained severe contralateral lower-limb trauma. We report a technique for salvaging the foot by replacing the degloved skin as a full-thickness graft and securing it using the vacuum-assisted closure (VAC) device. A good outcome was achieved and technical tips are provided to facilitate reproduction of the procedure.

Bone Wires↗
PubMed1997

Lower extremity alignment and risk of overuse injuries in runners.

A group of 304 runners enrolling in a marathon training program had alignment measurements performed and completed a questionnaire on training practices and injuries over the previous 12 months. The alignment measures consisted of arch index (AI), heel valgus (HV), knee tubercle-sulcus angle (TSA), knee varus (KV), and leg-length difference (LLD). Results indicated few consistent statistical associations between these alignment measures and risk of injuries, either bivariately or multivariately: left AI with hamstring injuries; right AI with shin injuries; right HV with back injuries; left TSA with ankle injuries; KV with hip injuries; and LLD with back, ankle, and foot injuries. A few statistically significant relationships were also found between other training and anthropometric factors and injuries: mileage with hamstring injuries; interval training with shin injuries; hard surfaces with back and thigh injuries; shoe use patterns with foot and overall injuries; and body mass index with heel injuries. We conclude that lower-extremity alignment is not a major risk factor for running injuries in our relatively low mileage cohort; however, prospective studies are necessary to confirm or refute these findings.

Adult↗
PubMed1989

Crush injuries of the foot with compartment syndrome: immediate one-stage management.

Severe crush injuries with compartment syndrome were treated in five patients by an immediate one-stage procedure. This procedure included the assessment of skin flap viability with accurate debridement of devascularized tissues. It was performed according to the split-thickness skin excision technique. Compartment pressures were measured and the fasciotomies were performed through open wounds or separate medial and lateral incisions. The medial incision was extended to release the tarsal tunnel. Fractures were reduced and internally fixed and exposed bones were covered with locally transposed muscles. Skin grafts, taken earlier for the skin viability assessment, were meshed and applied to replace skin loss. All wounds and fractures healed uneventfully with no major functional loss. In multiple trauma, the physician should maintain a high index of suspicion for early diagnosis and treatment of severe foot injuries. Early treatment leads to more desirable results, shorter hospitalization, and faster rehabilitation.

Adult↗
PubMed2005

Foot and ankle injuries in the adolescent runner.

PURPOSE OF REVIEW: To evaluate the increase in overuse injuries in the adolescent athlete, specifically sports-related injuries to the foot and ankle of the adolescent runner. Factors affecting these injuries include anatomic considerations, gender, rate of development, growth, training errors, shoe wear, and running surface. RECENT FINDINGS: Most injuries in adolescent runners are overuse injuries rather than sudden traumatic events. Adolescent athletes are as prone as adults to poor form, poor habits, and poor training patterns. In addition, anatomic variants in the hindfoot, midfoot, and forefoot may predispose an athlete to specific injury. SUMMARY: Adolescent running injuries are common and becoming more frequent as trainers and athletes place increasing demands on the growing body. There is no evidence that this increased demand produces long-term adverse effects; however, a significant amount of time can be lost to injuries unless training patterns are constructed to allow for repair of the adolescent athlete.

Adolescent↗